Active NPI
Maggie Buckhannon, SLP
- Speech-Language Pathologist
- Murray, UT
National Provider Identifier
1669149357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12369574-4104
- Practice address
- 5770 S. Fashion Blvd.
BLDG 5 Suite 210
Murray, UT 84107 - Phone
- (801) 314-5232
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12369574-4104 | UT | Primary |
Addresses
Primary practice location
5770 S. Fashion Blvd.
BLDG 5 Suite 210
Murray, UT 84107
Mailing address
4151 N Traverse Mountain Blvd Apt 14208
Lehi, UT 84043-2643
Phone (702) 506-5760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12369574-4104 | UT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1669149357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4151 N TRAVERSE MOUNTAIN BLVD APT 14208",
"city": "LEHI",
"state": "UT",
"postal_code": "840432643",
"telephone_number": "702-506-5760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5770 S. FASHION BLVD.",
"address_2": "BLDG 5 SUITE 210",
"city": "MURRAY",
"state": "UT",
"postal_code": "84107",
"telephone_number": "801-314-5232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKHANNON",
"first_name": "MAGGIE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2021-08-30",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "UT",
"license": "12369574-4104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.